Postoperative Pain After Caesarian Section

Control group (current analgesia, elective CS) is compared to current analgesia for emergency CS, and guideline recommended analgesia.

Current analgesia for CS:

Spinal hyperbaric bupivacaine 5 mg/ml, 9-11 mg. Spinal fentanyl 10-15 ug. Postoperative: Paracetamol 1g x 4, ibuprofen 400 mg x 4 po, oxycodone 10 mg (<70 kg) or 20 mg (>70 kg) x 2 po, additional oxycodone 2,5 mg iv/5 mg po when needed.

Guideline recommended analgesia for CS:

Spinal hyperbaric bupivacaine 5 mg/ml, 9-11 mg. Spinal fentanyl 12,5 ug. Spinal morphine 0,05 mg. After delivery of baby: Dexamethasone 8 mg iv, paracetamol 1g iv, parecoxib 40 mg iv.

Postoperative: Paracetamol 1g x 4, ibuprofen 600 mg x 4 po, oxycodone 2,5 mg iv/5 mg po when needed.

Inclusion criteria

• Healthy parturient, term pregnancy, undergoing caesarian section

Exclusion criteria

• Patient refusal
• Maternal heart or lung disease (not including mild asthma)
• Known or suspected obstructive sleep apnoea syndrome
• Pre-eclampsia
• Body mass index > 40
• Indulin-dependent diabetes mellitus
• Contraindications to ibuprofen, dexamethasone or morphine
• Chronic pain
• Neurological disease
• Drug abuse
• Age < 18 years
• American Society of Anesthesiologists (ASA) 3
• Patients receiving other forms of anaesthesia (epidural or general)